Vascular cognitive impairment

Introduction
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By John V Bowler MD and Vladimir C Hachinski MD

Vascular cognitive impairment is also known as or subsumes Vascular dementia. -ed.

Vascular cognitive impairment (VCI) has superseded vascular dementia because of the limitations of the concept of vascular dementia. In this article, the conceptual basis of vascular cognitive impairment is reviewed along with a critique of the old criteria for vascular dementia. Also reviewed are the recent developments in the management of vascular cognitive impairment, in which there have been advances in both slowing progression of disease and symptomatic relief.

Key Points

  • Subcortical vascular cognitive impairment due to small vessel cerebrovascular disease is the commonest form of vascular cognitive impairment.
  • Affected domains typically include frontal and executive functions.
  • Vascular cognitive impairment commonly coexists with Alzheimer disease and produces mixed dementia, which is the commonest form of dementia.
  • Multi-infarct dementia is rare.
  • Modern practice concentrates on early detection with a view to the prevention of progression wherever possible.